Journal articles on the topic 'Women's health services Papua New Guinea'
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Elia, Clerah R., and Sue Devine. "Barriers and enablers for cervical cancer screening in the Pacific: A systematic review of the literature." Pacific Journal Reproductive Health 1, no. 7 (August 20, 2018): 372. http://dx.doi.org/10.18313/pjrh.2018.905.
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Background: Globally cervical cancer is the fourth most common type of cancer in women and in some low-income countries is the most common cancer in women. Papua New Guinea has a particularly concerning incidence of cervical cancer where it ranks first as the leading cause of cancer in females. Screening is a reliable strategy to detect cervical cancer but implementation of screening in Papua New Guinea is poor. The aim of this review is to identify the enablers and barriers for cervical cancer screening in Papua New Guinea.
Methods: A systematic search of peer-reviewed literature was conducted using electronic databases; PubMed, Medline, Scopus, CINAHL and Google Scholar. Articles published between 2007 and 2017 that focused on the enablers and barriers to cervical cancer screening were included. Only one study from Papua New Guinea was identified so the search was extended to include other Pacific Island Countries and Low-Income Countries more broadly.
Findings: Twenty articles met the inclusion criteria. The main barriers for cervical cancer screening included a lack of women’s knowledge about cervical cancer and screening, a lack of health facilities for screening, diagnosis and treatment, lack of health care worker knowledge and training, cultural beliefs and financial burdens. The main enablers included women having access to education programs, availability of cervical cancer screening services, female friendly environments and health care workers being trained to undertake screening.
Conclusions: While the literature highlighted the importance of cervical cancer screening, a range of barriers limits the delivery of this service in low-income country settings. In particular, there is a gap in the knowledge of barriers and enablers within Papua New Guinea and further research in this country is required. Applying the knowledge learned from other low-income countries and gaining a clearer understanding of both the barriers and enablers for cervical cancer screening in the Papua New Guinea context may lead to clear recommendations to improve implementation and uptake of cervical cancer screening.
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McKenzie, Maviso. "Experiences of men’s involvement in antenatal education services in the rural Eastern Highlands Province of Papua New Guinea: a descriptive qualitative study." Pacific Journal Reproductive Health 1, no. 7 (August 20, 2018): 346. http://dx.doi.org/10.18313/pjrh.2018.901.
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Background: Appropriate antenatal education services that increase men’s involvement in pregnancy and childbirth is crucial for improving maternal and child health outcomes. However, in Papua New Guinea (PNG), men’s involvement in antenatal education services remains inadequate. This study aimed to describe experiences of men’s involvement in antenatal education services and identify factors that facilitate or restrict their involvement.
Methods: A qualitative study was conducted among 17 men who have attended antenatal care (ANC) and involved in antenatal education sessions with their wives. Semi-structured and face-to-face interviews were employed to obtain detailed descriptions of men’s experiences and their perception of antenatal health education services, including factors that influenced their involvement. Data is generated from interviews. The findings are informed by the thematic analysis.
Results: Three key themes that emerged were: (1) perception of ANC as women’s domain, (2) knowledge of antenatal education services, and (3) accessing of antenatal education services. Factors influencing men’s involvement were: strict gender roles, being responsible for pregnancy and spousal communication. Lack of knowledge, dissatisfaction with antenatal services, and lack of capacity to involve men were other reasons further observed.
Conclusion: This study found negative perceptions; poor maternal knowledge and socio-cultural norms, inadequate information dissemination and poor men-friendly services influenced men’s involvement. Suggestions to strengthen men’s involvement require gender-inclusive and culturally appropriate antenatal education programs.
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Campos-Outcalt, Doug. "Health services in Papua New Guinea." Public Health 103, no. 3 (May 1989): 161–69. http://dx.doi.org/10.1016/s0033-3506(89)80070-8.
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Campos-Outcalt, Doug, and William Newbrander. "Decentralization of health services in Papua New Guinea." Health Policy and Planning 4, no. 4 (1989): 347–53. http://dx.doi.org/10.1093/heapol/4.4.347.
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NEWBRANDER, WILLIAM C., and JANE A. THOMASON. "Alternatives for financing health services in Papua New Guinea." Health Policy and Planning 4, no. 2 (1989): 131–40. http://dx.doi.org/10.1093/heapol/4.2.131.
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Williams, Ged, Rose Jaspers, Veronica Wohuinangu, Svatka Micik, and Adrian De Luca. "Critical Care Nursing in Papua New Guinea." Connect: The World of Critical Care Nursing 14, no. 1 (March 1, 2020): 35–44. http://dx.doi.org/10.1891/wfccn-d-20-00011.
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ObjectiveTo explore and understand the current context of critical care nursing in Papua New Guinea (PNG).MethodA three day fact finding mission and consulation process with leaders of critical care and health services in PNG.ResultsAlthough challenged by limited resources and healthcare infrastructure there is a determination among local health care providers to growth and improve the provision of critical care services from the major hospitals of PNG. The PNG Critical Care Nurses Society (PNG CCNS) was officially formed in March 2020, providing hope and optimism for a renewed emphasis on this important speciality in PNG.ConclusionThe authors and the PNG CCNS recommend the establishment of active and supportive partnerships with other critical care leaders of the world to help guide future developments in PNG.
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Thomason, Jane, Navy Mulou, and Caroline Bass. "User charges for rural health services in Papua New Guinea." Social Science & Medicine 39, no. 8 (October 1994): 1105–15. http://dx.doi.org/10.1016/0277-9536(94)90382-4.
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Hinton, Rachael, and Jaya Earnest. "The right to health: Overcoming inequalities and barriers to women's health in Papua New Guinea." Women's Studies International Forum 33, no. 3 (May 2010): 180–87. http://dx.doi.org/10.1016/j.wsif.2009.12.006.
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Thomason, Jane, and Keith Edwards. "Using indicators to assess quality of hospital services in Papua New Guinea." International Journal of Health Planning and Management 6, no. 4 (October 1991): 309–24. http://dx.doi.org/10.1002/hpm.4740060406.
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Hinton, Rachael, and Jaya Earnest. "Assessing women's understandings of health in rural Papua New Guinea: Implications for health policy and practice." Asia Pacific Viewpoint 52, no. 2 (August 2011): 178–93. http://dx.doi.org/10.1111/j.1467-8373.2011.01449.x.
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Beracochea, Elvira, Rumona Dickson, Paul Freeman, and Jane Thomason. "Case Management Quality Assessment in Rural Areas of Papua New Guinea." Tropical Doctor 25, no. 2 (April 1995): 69–74. http://dx.doi.org/10.1177/004947559502500207.
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A study was carried out to assess the quality of case management of malaria, malnutrition, diarrhoea and acute respiratory tract infections in children in rural primary health services in Papua New Guinea. In particular, the study focused on the knowledge and skills of different categories of rural health workers (HW) in history taking, examination, diagnosis, treatment and patient education. Quality criteria were defined and health centre (HCW) and aidpost workers' (APWs) knowledge and practices were assessed. Primary health workers' (PHW) knowledge of case management was weak, but in all cases better than their actual practice. History taking and examination practices were rudimentary. HWs tended not to make or record diagnoses. Treatment knowledge was often incorrect, with inappropriate or insufficient drugs prescribed, being worst at aidpost level. These findings raise serious questions about the effectiveness of providing health services through small, isolated health units. Far greater attention must now be directed to focus on the institutionalization of problem-based training, continuous supportive supervision and maintenance of clinical skills and provision of essential drugs, supplies and equipment to ensure that rural health workers (RHW) can provide sound care.
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Garner, P., and J. Thomason. "Setting Standards for Primary Health Services." Tropical Doctor 23, no. 4 (October 1993): 147–48. http://dx.doi.org/10.1177/004947559302300403.
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Primary health service coverage has increased in many developing countries over the last 10 years. The number of components included in the basic package has also expanded. This has led in some countries to primary health workers becoming overloaded with responsibilities. To maintain high quality care, primary health workers not only need appropriate training, but clear performance guidelines, as well as essential resources and supportive supervision. We report on the establishment of standards for primary health services by the Ministry of Health in Papua New Guinea (PNG).
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Biddulph, John. "The Role and Training of Hospital Paediatric Nurses in Papua New Guinea." Paediatrica Indonesiana 16, no. 1-2 (September 12, 2019): 21–6. http://dx.doi.org/10.14238/pi16.1-2.1976.21-6.
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Demands for health services are increasing in all countries of the world.
Both affluent and less affluent countries are starting to realise to the importance of nurse practitioners to enable comprehensive health services to be made available to more people at cheaper cost.
The training programme for hospital paediatric nurses in Papua New Guinea has been designed to allow them to carry out effectively their future role of taking responsibility for the screening, diagnosis and initial treatment of sick children pending the availability of a doctor.
The nurses receive practical on the job training by rotating through specific areas during the one year post basic course in paediatric nursing. The areas are acute paediatric ward, gastroenteritis ward, special care nursery, paediatric outpatients, nutrition rehabilitation unit and MCH clinics.
The nurses learn to diagnose the common acute paediatric illnesses. They learn standardised management regimens for each of these common childhood illnesses.
They also learn how to carry out the practical procedures required to allow them to diagnose and treat these illnesses, and become skilled in doing such procedures as lumbar punctures and intravenous rehydration.
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Chae, Young Moon, William C. Newbrander, and Jane A. Thomason. "Application of goal programming to improve resource allocation for health services in Papua New Guinea." International Journal of Health Planning and Management 4, no. 2 (April 1989): 81–95. http://dx.doi.org/10.1002/hpm.4740040203.
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Karel, Harumi Sasaki. "Knowledge and Use of Maternal and Child Health Services by Mothers in Papua New Guinea." Asia Pacific Journal of Public Health 7, no. 3 (July 1994): 191–93. http://dx.doi.org/10.1177/101053959400700308.
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A survey was conducted in the coastal area of Morobe Province in Papua New Guinea between March to April 1992 in order to obtain and examine the current health knowledge and practices of mothers with children under two years of age. The purpose of the survey was to gather data for the detailed planning and implementation of a Child Survival Intervention Project funded by USAID. A total of 30 villages in the area were selected utilizing the WHO 30-cluster sampling technique. The results indicated that breastfeeding was a very common practice. However, because nutritional intake was not increased during pregnancy and lactation for many of the women, it is likely that their nutritional intake was insufficient. Although many mothers knew the importance of immunization, they were unclear about the importance of completing immunization series. The utilization of contraceptive methods was very low among women who did not want to have another child within the subsequent two years. The most common methods were injections and pills. The dissemination of health education to isolated rural villages is one of the most important interventions in reducing maternal and infant mortality. As there currently is no health education unit at the Morobe Provincial Department of Health. It is crucial to establish the unit and to emphasize the importance of health education as the tool for disease prevention and health promotion. Asia Pac J Public Health1994;7(3):191-3.
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Jusi, Petri, Roy Mumu, Sirpa H. Jarvenpaa, Barnabas Neausemale, and Eduardo Sangrador. "Road Asset Management System Implementation in Pacific Region: Papua New Guinea." Transportation Research Record: Journal of the Transportation Research Board 1819, no. 1 (January 2003): 323–32. http://dx.doi.org/10.3141/1819b-41.
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The road network of Papua New Guinea includes 8,258 km of national classified roads and another 19,937 km of lesser-trafficked but equally important provincial roads. The value of the national road network is more than 5 billion Kina (US$1 billion). Maintaining this significant asset places a great responsibility on the government and the Department of Works (DOW). Sadly, insufficient attention has been given to maintaining the road network. There is no doubt that poorly maintained roads have a significant adverse effect on national economic growth, with an adverse effect on gross domestic product. In a developing country such as Papua New Guinea, there is always a need to provide a basic level of access to all areas of the country to be able to provide basic services for all the population (access to markets, administrative, health, education). A poorly maintained road network limits access and deprives rural populations of basic services. Therefore, DOW, with funds and guidance provided by the Asian Development Bank, has, with the assistance of a Finnroad consultant, developed a road asset management system (RAMS). RAMS is a tool for storing and presenting road data information, planning short-and long-term road maintenance, creating budgets, and maximizing economic returns of investments made for the road network. The government of Papua New Guinea has also established requirements for institutional reform and strengthening under its public sector reform program. Furthermore, responding to community and other stakeholder pressure, the government has committed itself to launching a road sector reform program.
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Byford, Julia. "Doctoral dissertation — Dealing with death beginning with birth: Women's health and childbirth on Misima Island, Papua New Guinea." Australian Midwifery 18, no. 1 (May 2005): 30. http://dx.doi.org/10.1016/s1448-8272(05)80018-5.
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Au, Nicole, Bruce Hollingsworth, and Jean Spinks. "Measuring the Efficiency of Health Services in Lower-income Countries: The Case of Papua New Guinea." Development Policy Review 32, no. 2 (February 3, 2014): 259–72. http://dx.doi.org/10.1111/dpr.12054.
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Thomason, Jane A. "Disbursement, decentralization and development: Lessons from the first rural health services project in Papua New Guinea." Public Administration and Development 8, no. 4 (October 1988): 391–99. http://dx.doi.org/10.1002/pad.4230080403.
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Hocking, Jane S., Cathy Vaughan, Andrew Lau, Dorothy A. Machalek, and Simon Graham. "Reducing the burden of sexually transmissible infections in Papua New Guinea requires strengthening of clinical services and engaging men." Sexual Health 13, no. 5 (2016): 401. http://dx.doi.org/10.1071/sh16058.
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In this edition of Sexual Health, Vallely et al. report the results of a cross-sectional prevalence survey of sexually transmissible infections (STIs) among women attending their first antenatal visit in three provinces of Papua New Guinea (PNG). This Editorial examines potential reasons for these high prevalence estimates and discusses strategies for addressing high STIs rates in PNG.
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Lewis, Ione R. "At Risk: The Relationship between Experiences of Child Sexual Abuse and Women's HIV Status in Papua New Guinea." Journal of Child Sexual Abuse 21, no. 3 (May 2012): 273–94. http://dx.doi.org/10.1080/10538712.2012.668265.
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Schuele, Elisabeth, and Colin MacDougall. "The missing bit in the middle: Implementation of the Nationals Health Services Standards for Papua New Guinea." PLOS ONE 17, no. 6 (June 24, 2022): e0266931. http://dx.doi.org/10.1371/journal.pone.0266931.
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Objective This case study examined implementation of the National Health Services Standards (NHSSs) as a continuous quality improvement (CQI) process at three church-based health facilities in Papua New Guinea. This process was designed to improve quality of care and accredit the level three health centers to level four as district hospitals to provide a higher level of care. The aims of the paper are to critically examine driving and restraining forces in CQI implementation and analyses how power influences agenda setting for change. Methods Semi-structured interviews were conducted with nine managers and eight health workers as well as three focus group discussions with health workers from three rural church-based health facilities in Morobe and Madang provinces. They included senior, mid-level and frontline managers and medical doctors, health extension officers, nursing officers and community health workers. Thematic analysis was used as an inductive and deductive process in which applied force field analysis, leadership-member exchange (LMX) theory and agenda setting was applied. Results Qualitative analysis showed how internal and external factors created urgency for change. The CQI process was designed as a collective process. Power relations operated at and between various levels: the facilities, which supported or undermined the change process; between management whereby the national management supported the quality improvement agenda, but the regional management exercised positional power in form of inaction. Theoretical analysis identified the ‘missing bit in the middle’ shaped by policy actors who exercise power over policy formulation and constrained financial and technical resources. Analysis revealed how to reduce restraining forces and build on driving forces to establish a new equilibrium. Conclusion Multiple theories contributed to the analysis showing how to resolve problematic power relations by building high-quality, effective communication of senior leadership with mid-level management and reactivated broad collaborative processes at the health facilities. Addressing the ‘missing bit in the middle’ by agenda setting can improve implementation of the NHSSs as a quality improvement process. The paper concludes with learning for policy makers, managers and health workers by highlighting to pay close attention to institutional power dynamics and practices.
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Burnett, Anthea, Mitasha Yu, Prakash Paudel, Thomas Naduvilath, Tim R. Fricke, Yvonne Hani, and Jambi Garap. "Perceptions of Eye Health and Eye Health Services among Adults Attending Outreach Eye Care Clinics in Papua New Guinea." Ophthalmic Epidemiology 22, no. 6 (November 2, 2015): 361–69. http://dx.doi.org/10.3109/09286586.2015.1057604.
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Hill, Genia, Rachel Friedman, and Paul Dargusch. "Food Systems Development: The Necessary Paradigm Shift for a Healthy and Sustainable Agrarian Transition, a Case Study from Bougainville, Papua New Guinea." International Journal of Environmental Research and Public Health 19, no. 8 (April 12, 2022): 4651. http://dx.doi.org/10.3390/ijerph19084651.
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Classical agricultural development paradigms prioritise basic requirements such as agronomic, caloric and economic needs for the target environment and for beneficiaries. As challenges associated with climate change, globalisation, and population growth compound and amplify one another, project scope must be broadened to take a holistic food systems approach that includes sociocultural and historical contexts, as well as climate impacts as underpinning project design. In this paper, we illustrate the importance of adopting a food systems development paradigm rather than a classical agricultural development paradigm through a case study in Bougainville, Papua New Guinea. The case uses Rich Picturing, targeted and focus-group interviews, and garden visits in remote Bougainville; it provides a poignant illustration of the importance of this more holistic perspective given the historical inefficacy of food systems development, as well as Papua New Guinea’s exposure to a plethora of compounding environmental, social, economic, and political stresses and shocks that demonstrate the important linkages between ecosystem services and health. The study aims to demonstrate how including localised gender dynamics, climate vulnerability, rapidly morphing social norms, and climate analogue environments is critical in building food systems resilience and is key to designing policies, programs, and development projects that more effectively address environmental, sociocultural, and health considerations. Building on the inadequacies in agricultural development efforts previously documented for Papua New Guinea, we propose an improved framing for food systems development and identify areas for future research.
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Owusu-Afriyie, Bismark, Isabelle Baimur, Theresa Gende, and Thomas Baia. "Prevalence of Risk Factors of Retinal Diseases among Patients in Madang Province, Papua New Guinea." International Journal of Clinical Practice 2022 (September 5, 2022): 1–8. http://dx.doi.org/10.1155/2022/6120908.
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Purpose. To explore the prevalence of risk factors of retinal diseases among patients seeking services from Madang Provincial Hospital Eye Clinic in Papua New Guinea. Materials and Methods. A hospital-based retrospective study was conducted at the only eye clinic serving the entire Madang province of Papua New Guinea. Purposive sampling was used to obtain data from patients’ record cards at the eye clinic from January to June 2021. The data collected included gender, age, presenting visual acuity, blood pressure, blood sugar level, body mass index, smoking habits, and history of cataract surgery. The data was analyzed using the International Business Machines Corporation’s Statistical Package for Social Sciences version 21. A p -value of <0.05 was considered statistically significant. Results. Two hundred and fifty-five (255) patients went through diabetes and hypertension screening during the period of the study (January to June 2021). The mean age of the patients was 53.14 ± 11.20 years and there were more males (56.86%) than females. Nearly half of the patients (43.6%) were either visually impaired or blind. More than half (52.6%) had diabetes mellitus. Majority of the patients (73.3%) were hypertensive and more than half (57.0%) of the patients had unhealthy body mass index (BMI <18.525 kg/m2 or > 25 kg/m2). Overweight was significantly associated with hypertension ( p < 0.001 ) and diabetes mellitus ( p < 0.001 ). A few of them were smokers or had a history of cataract surgery (13.7% and 2.0%, respectively). Conclusion. There is a high prevalence of diabetes, hypertension, and overweight among ophthalmic patients in Madang. It is important that measures are put in place to eliminate barriers to health care and to strengthen eye care services in Papua New Guinea.
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Gray, Richard T., Lei Zhang, Tony Lupiwa, and David P. Wilson. "Forecasting the Population-Level Impact of Reductions in HIV Antiretroviral Therapy in Papua New Guinea." AIDS Research and Treatment 2011 (2011): 1–8. http://dx.doi.org/10.1155/2011/891593.
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Papua New Guinea (PNG) recently did not secure external funding for the continuation of its antiretroviral treatment (ART) programs meaning that supplies of HIV drugs for the estimated 38,000 people living with HIV in PNG could be completely depleted during 2010. Using a mathematical model of HIV transmission calibrated to available HIV epidemiology data from PNG, we evaluated the expected population-level impact of reductions in ART availability. If the number of people on ART falls to 10% of its current level, then there could be an approximately doubling in annual incidence and an additional 12,848 AIDS-related deaths (100.7% increase) over the next 5 years; if ART provision is halved, then annual incidence would increase by ~68%, and there would be an additional ~10,936 AIDS-related deaths (85.7% increase). These results highlight that maintenance of ART and associated services through external funding is essential for the health and well-being of HIV-positive people in PNG.
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Lokuge, Kamalini, Meggy Verputten, Maryanne Ajakali, Bianca Tolboom, Grace Joshy, Katherine A. Thurber, Daisy Plana, Steven Howes, Anastasia Wakon, and Emily Banks. "Health Services for Gender-Based Violence: Médecins Sans Frontières Experience Caring for Survivors in Urban Papua New Guinea." PLOS ONE 11, no. 6 (June 10, 2016): e0156813. http://dx.doi.org/10.1371/journal.pone.0156813.
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Lee, Ling, Fabrizio D'Esposito, Jambi Garap, Geoffrey Wabulembo, Samuel Peter Koim, Drew Keys, Anaseini T. Cama, Hans Limburg, and Anthea Burnett. "Rapid assessment of avoidable blindness in Papua New Guinea: a nationwide survey." British Journal of Ophthalmology 103, no. 3 (May 23, 2018): 338–42. http://dx.doi.org/10.1136/bjophthalmol-2017-311802.
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ObjectiveTo estimate the prevalence and main causes of blindness and vision impairment in people aged 50 years and older in Papua New Guinea (PNG).DesignNational cross-sectional population-based survey in National Capital District (NCD), Highlands, Coastal and Islands regions.MethodsAdults aged 50 years and above were recruited from 100 randomly selected clusters. Each participant underwent monocular presenting and pinhole visual acuity (VA) assessment and lens examination. Those with pinhole VA<6/12 in either eye had a dilated fundus examination to determine the primary cause of reduced vision. Those with obvious lens opacity were interviewed on barriers to cataract surgery.ResultsA total of 4818 adults were examined. The age-adjusted and sex-adjusted prevalence of blindness (VA <3/60), severe vision impairment (SVI, VA <6/60 but ≥3/60), moderate vision impairment (MVI, VA <6/18 but ≥6/60) and early vision impairment (EVI, VA <6/12 but ≥6/18) was 5.6% (95% CI 4.9% to 6.3%), 2.9% (95% CI 2.5% to 3.4%), 10.9% (95% CI 9.9% to 11.9%) and 7.3% (95% CI 6.6% to 8.0%), respectively. The main cause of blindness, SVI and MVI was cataract, while uncorrected refractive error was the main cause of EVI. A significantly higher prevalence of blindness, SVI and MVI occurred in the Highlands compared with NCD. Across all regions, women had lower cataract surgical coverage and spectacle coverage than men.ConclusionsPNG has one of the highest reported prevalence of blindness globally. Cataract and uncorrected refractive error are the main causes, suggesting a need for increased accessible services with improved resources and advocacy for enhancing eye health literacy.
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Yann, Meunier. "A public health program and others for about 10,000 villagers in the Kutubu area of Papua New Guinea (PNG)." Community Medicine and Health Education Research 1, no. 1 (December 14, 2019): 25–30. http://dx.doi.org/10.33702/cmher.201901.1.4.
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The paper describes the health conditions in villages of the Kutubu area in the Southern Highlands province of Papua New Guinea from 1993 to 1995. A set of actions were planned aiming at improving the health status of people living in these villages as well as the efficiency of medical services provided to these communities through a public health program, which did not exist earlier. After two years, it was shown that the combination of an adequate action plan, appropriate human and financial resources can produce significant results and marked improvement health wise for a population in dire needs.
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Heywood, Peter F., and Robin L. Hide. "Nutritional Effects of Export-Crop Production in Papua New Guinea: A Review of the Evidence." Food and Nutrition Bulletin 15, no. 3 (September 1994): 1–17. http://dx.doi.org/10.1177/156482659401500305.
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The effects of cash cropping on nutrition in Papua New Guinea are reviewed. The interpretation of the available evidence is complicated by the introduction of cash cropping simultaneously with services such as health and education of the rural population. However, there is indication that the growth of children improved over the period in which cash cropping increased, particularly in the highlands, where, as a result of the later introduction of cash crops, more baseline data are available. There is no reason to believe that the same effect did not occur in the lowlands, where the infant mortality rate fell progressively over the same period. There is also evidence of an increase in the height and weight of adults, as well as an increase in the prevalence of degenerative diseases. Programmes need to be developed that retain the important benefits of child health and at the same time arrest the increasing prevalence of degenerative diseases in adults.
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Pugu, Melyana Ratana, and Yanyan Mochamad Yani. "HUMAN SECURITY FOR BORDER SOCIETY: A CASE STUDY AT WARIS COMMUNITY AT THE BORDERS OF RI-PNG." Jurnal Asia Pacific Studies 3, no. 1 (July 5, 2019): 11. http://dx.doi.org/10.33541/japs.v3i1.972.
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This research is aimed to explain the border society situation at Waris District, which is located remote from government services. This condition reflects a threat on human security at the borders in Keerom regency, Papua, which is directly bordering Papua New Guinea (PNG). This research uses qualitative research method, in which it explains the human security threat in education and health at Waris District, which borders PNG. The education and health improvement and development for Waris community are organized through the provision infrastructure such as: the number of schools, teachers, community health centres. These are the indicators for the education and health improvement and development in the border region. The outcome of this research is a reference for the government in border region management in the sectors of education and health, as an effort to minimise human security threat for the Waris community at the borders between RI-PNG.
Keywords: Human Security, Border Society, Waris, Indonesia, Papua New Guinea
Abstrak
Penelitian ini bertujuan untuk menjelaskan situasi masyarakat perbatasan di Distrik Waris yang berlokasi terpencil jauh dari pelayanan publik dari pemerintah. Kondisi ini menyebabkan adanya ancaman terhadap keamanan manusia di daerah perbatasan Kabupaten Keerom, Papua yang langsung berbatasan dengan Papua Nugini. Penelitian ini menggunakan metode penelitian kualitatif untuk menjelaskan ancaman terhadap keamanan manusia di bidang pendidikan dan kesehatan di Distrik Waris yang berbatasan langsung dengan Papua Nugini. Pembangunan dan peningkatan bidang pendidikan dan kesehatan dilakukan melalui pengadaan infrastruktur seperti jumlah sekolah, guru, pusat-pusat kesehatan masyarakat. Ini semua merupakan indikator untuk pembangunan dan peningkatan bidang pendidikan dan kesehatan di kawasan perbatasan. Hasil penelitian menjadi bahan masukan bagi pemerintah dalam mengelola kawasan perbatasan terutama di sector pendidikan dan kesehatan, sebagai upaya untuk meminimalkan ancaman terhadap keamanan manusia di Distrik Waris yang berada di daerah perbatasan antara Republik Indonesia dan Papua Nugini.
Kata Kunci: Keamanan Manusia, Masyarakat Perbatasan, Waris, Indonesia, Papua Nugini
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Campos-Outcalt, Doug, Kelly Kewa, and Jane Thomason. "Decentralization of health services in Western Highlands Province, Papua New Guinea: An attempt to administer health service at the subdistrict level." Social Science & Medicine 40, no. 8 (April 1995): 1091–98. http://dx.doi.org/10.1016/0277-9536(94)00222-f.
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Hou, Xiaohui, M. Mahmud Khan, Justin Pulford, and Olga P. M. Saweri. "Readiness of health facilities to provide emergency obstetric care in Papua New Guinea: evidence from a cross-sectional survey." BMJ Open 12, no. 2 (February 2022): e050150. http://dx.doi.org/10.1136/bmjopen-2021-050150.
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ObjectiveTo measure the readiness of health facilities in Papua New Guinea (PNG) to provide obstetric care and other maternal health services.DesignCross-sectional study involving random sample of health centres, district/rural hospitals (levels 3 and 4 facilities) and all upper-level hospitals operational at the time of survey. Structured questionnaires were used to collect data from health facilities.SettingHealth facilities in PNG. Facility administrators and other facility personnel were interviewed. Number of facility personnel interviewed was usually one for health centres and two or more for hospitals.Participants19 upper-level facilities (levels 5–7, provincial, regional and national hospitals) and 60 lower-level facilities (levels 3 and 4, health centres and district/rural hospitals).Outcome measuresFour service-types were used to understand readiness of surveyed health facilities in the provision of maternity care including obstetric care services: (1) facility readiness to provide clinical services; (2) availability of family planning items; (3) availability of maternal and neonatal equipment and materials; and (4) ability to provide emergency obstetric care (EmOC).Results56% of lower-level facilities were not able to provide basic emergency obstetric care (BEmOC). Even among higher-level facilities, 16% were not able to perform one or more of the functions required to be considered a BEmOC provider. 11% of level 3 and 4 health facilities were able to provide comprehensive emergency obstetric care (CEmOC) as compared with 83% of higher-level facilities.ConclusionGiven the high fertility rate and maternal mortality ratio (MMR) in PNG, lack of BEmOC at the first level inpatient service providers is a major concern. To improve access to EmOC, level 3 and 4 facilities should be upgraded to at least BEmOC providers. Significant reduction in MMR will require improved access to CEmOC and optimal geographic location approach can identify facilities to be upgraded.
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Herwando, Herwando, and Taufiq Hamzah Sitompul. "Evaluasi Manfaat Penerapan Telemedicine di Negara Kepulauan: Systematic Literature Review." Indonesian of Health Information Management Journal (INOHIM) 9, no. 2 (December 31, 2021): 91–101. http://dx.doi.org/10.47007/inohim.v9i2.261.
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AbstractTelemedicine is the use of medical information exchanged from one site to another through electronic communication to improve the clinical health status of patients. Telemedicine can be one of the solution options to overcome the limitations of health workers. This study aims to describe the benefits of implementing Telemedicine in archipelagic countries. This type of research is a Systematic Literature Review with literature sourced from Elsevier, Garuda, IEEE Xplore, NCBI, PubMed, ProQuest, ResearchGate, Science Direct, and Springer. Literature selection using PRISMA, obtained 257 scientific articles consisting of duplicate data 15, did not enter the topic 73, did not meet the inclusion & exclusion criteria 154, did not meet the minimum standard of SRQR 4 and only 10 were used. The results of the analysis obtained are 5 of the 19 archipelagic countries that are related, namely Cape Verde, the Philippines, Indonesia, Papua New Guinea, and Sao Tome & Principe. Furthermore, improving access to care in the form of eliminating trips that are burdensome for patients, making it easier for patients to access health services through patient devices. The nearest Telemedicine satellite device. Then the timeliness in treatment is to facilitate the diagnosis of patients and patient health care. Then the increase in patient satisfaction and involvement of patient satisfaction and patient involvement. Meanwhile, the increase in demand and cost-effectiveness is obtained in the form of efficient services, increasing patient expectations. The benefits of implementing Telemedicine are mostly in Cape Verde and the least in Papua New Guinea. Keywords: telemedicine, telemedicine application, archipelago country AbstrakTelemedicine sebagai penggunaan informasi medis yang dipertukarkan dari satu situs ke situs lain melalui komunikasi elektronik untuk meningkatkan status kesehatan klinis pasien. Telemedicine bisa menjadi salah satu opsi solusi mengatasi keterbatasan tenaga kesehatan. Penelitian ini bertujuan mendeskripsikan manfaat penerapan Telemedicine di negara kepulauan. Jenis penelitian Sytematic Literature Review dengan literatur bersumber dari Elsevier, Garuda, IEEE Xplore, NCBI, PubMed, ProQuest, ResearchGate, Science Direct, dan Springer. Seleksi literatur menggunakan PRISMA, diperoleh 257 artikel ilmiah terdiri dari duplikasi data 15, tidak masuk topik 73, tidak masuk kriteria inklusi & eksklusi 154, tidak masuk standar minimal SRQR 4 dan hanya 10 yang digunakan. Hasil analisis yang diperoleh ada 5 dari 19 negara kepulauan yang terkait yakni Cape Verde, Filipina, Indonesia, Papua New Guinea, dan Sao Tome & Principe.Selanjutnya pada peningkatan akses perawatan berupa menghilangkan perjalanan yang memberatkan pasien, memudahkan pasien mengakses layanan kesehatan melalui perangkat pasien/perangkat satelit Telemedicine terdekat. Lalu ketepatan waktu dalam perawatan yakni memudahkan penegakan diagnosis pasien dan perawatan kesehatan pasien. Kemudian peningkatan kepuasan dan keterlibatan pasien adanya kepuasan pasien dan keterlibatan pasien. Sedangkan pada peningkatan permintaan dan hemat biaya diperoleh berupa layanan yang efisien, meningkatnya ekspektasi pasien. Adapun manfaat penerapan Telemedicine paling banyak di negara Cape Verde dan paling sedikit di Papua New Guinea.Kata Kunci: telemedicine, penerapan telemedicine, negara kepulauan
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Kingi, Roman, Wani Erick, Vili Hapaki Nosa, Janine Paynter, and Debra de Silva. "Pasifika preferences for mental health support in Australia: focus group study." Pacific Health Dialog 21, no. 7 (June 22, 2021): 373–79. http://dx.doi.org/10.26635/phd.2021.110.
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Introduction: Mental wellbeing is a growing health issue for Pacific Islands communities (Pasifika), particularly amongst people who have resettled in a different country. We explored whether Pasifika people living in Australia think mental health services meet their needs. Methods: We ran eight two-hour focus groups with 183 adults living in Queensland, Australia. There were representatives from the following ethnic groups: Cook Islands, Fiji, Maori, Niue, Papua New Guinea, Samoa, Tokelau and Tonga. We also included mental health providers. We analysed the feedback using thematic analysis. Findings: Pasifika people welcomed having an opportunity to discuss mental wellbeing openly. They said that economic issues, social isolation, cultural differences, shame and substance use contributed to increasingly poor mental health amongst Pasifika communities in Australia. They wanted to work with mainstream services to develop culturally appropriate and engaging models to support mental wellbeing. They suggested opportunities to harness churches, community groups, schools, social media and radio to raise awareness about mental health. Conclusions: Working in partnership with Pasifika communities could strengthen mainstream mental health services and reduce the burden on acute services in Australia. This could include collecting better ethnicity data to help plan services, empowering community structures to promote mental wellbeing and training staff to support Pasifika communities. The key message was that services can work ‘with’ Pasifika communities, not ‘to’ them.
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Toikilik, Steven, George Tuges, Jamie Lagani, Elis Wafiware, Enoch Posanai, Ben Coghlan, Christopher Morgan, et al. "Are hard-to-reach populations being reached with immunization services? Findings from the 2005 Papua New Guinea national immunization coverage survey." Vaccine 28, no. 29 (June 2010): 4673–79. http://dx.doi.org/10.1016/j.vaccine.2010.04.063.
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Ropa, Barry, James Flint, Michael O'Reilly, Boris Igor Pavlin, Rosheila Dagina, Bethseba Peni, Mathias Bauri, et al. "Lessons from the first 6 years of an intervention-based field epidemiology training programme in Papua New Guinea, 2013–2018." BMJ Global Health 4, no. 6 (December 2019): e001969. http://dx.doi.org/10.1136/bmjgh-2019-001969.
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Papua New Guinea (PNG) faces a critical shortage of human resources to address pressing public health challenges arising from an increasing burden of communicable and non-communicable diseases. PNG is an independent State in the Pacific and home to 8.2 million people. Resource and infrastructure constraints due to the country’s challenging geography have made it difficult and expensive to deliver health services and implement health programmes. The National Department of Health and its partners developed a field epidemiology training programme of Papua New Guinea (FETPNG) to strengthen the country’s public health workforce. The training programme covers field epidemiology competencies and includes the design, implementation and evaluation of evidence-based interventions by Fellows. From 2013 to 2018, FETPNG graduated 81 field epidemiologists. Most FETPNG graduates (84%) were from provincial or district health departments or organisations. Many of their intervention projects resulted in successful public health outcomes with tangible local impacts. Health challenges addressed included reducing the burden of multi-drug resistant-tuberculosis (TB), increasing immunisation coverage, screening and treating HIV/TB patients, and improving reproductive health outcomes. FETPNG Fellows and graduates have also evaluated disease surveillance systems and investigated disease outbreaks. Early and unwavering national ownership of FETPNG created a sustainable programme fitting the needs of this low-resource country. A focus on designing and implementing effective public health interventions not only provides useful skills to Fellows but also contributes to real-time, tangible and meaningful improvements in the health of the population. The graduates of FETPNG now provide a critical mass of public health practitioners across the country. Their skills in responding to outbreaks and public health emergencies, in collecting, analysing and interpreting data, and in designing, implementing and evaluating public health interventions continues to advance public health in PNG.
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Owusu-Afriyie, Bismark, Anne Caleb, Lorraine Kube, and Theresa Gende. "Knowledge and Awareness of Diabetes and Diabetic Retinopathy among Patients Seeking Eye Care Services in Madang Province, Papua New Guinea." Journal of Ophthalmology 2022 (June 1, 2022): 1–10. http://dx.doi.org/10.1155/2022/7674928.
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Purpose. To assess the knowledge and awareness of diabetes and diabetic retinopathy among ophthalmic patients in Madang. Materials and Methods. This was a hospital-based study conducted at Madang Provincial Hospital Eye Clinic in Papua New Guinea. The study included all patients who visited the facility during the period of the study. A structured questionnaire was used to collect data on the patients’ demographics and their knowledge and awareness about diabetes and diabetic retinopathy. Results. A total of 203 (97.6%) patients consented and participated in the study out of 208 patients who were approached. The age of participants ranged from 19 to 78 years with a median (IQR) of 41 (53–29) years. 107 (52.7%) were female participants. A majority of the participants (62.6%) had at least secondary education. A few of the participants (3.9%) had known diabetes, and 134 (66%) had no relatives or friends with diabetes. A total of 145 (71.4%) participants knew that diabetes can affect the eye. Most of the participants (93.6%) checked their eyes only when their vision was affected, 161 (79.3%) agreed that regular eye checks are necessary, and more than half (54.2%) knew that diabetes can lead to blindness. Age, gender, level of education, and whether a participant or participant’s friends and relatives had been diagnosed with diabetes were significantly associated with the knowledge and awareness of participants about diabetes and diabetic retinopathy. Conclusion. A majority of the participants had good knowledge of diabetes and diabetic retinopathy. Health education and promotion will also help increase the awareness of diabetes and diabetic retinopathy in the country.
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Gray, Natalie, Peter Azzopardi, Elissa Kennedy, Elise Willersdorf, and Mick Creati. "Improving Adolescent Reproductive Health in Asia and the Pacific." Asia Pacific Journal of Public Health 25, no. 2 (July 31, 2011): 134–44. http://dx.doi.org/10.1177/1010539511417423.
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Data on adolescent reproductive health (ARH) are required to inform evidence-based policies and programs. The reports of national-level household surveys such as the Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) are important sources of such data in developing countries. The aim of this study was to map data on ARH from DHS and MICS reports from selected countries in the Asia and Pacific regions. The DHS and MICS reports for Bangladesh, Cambodia, Indonesia, Papua New Guinea, Philippines, Solomon Islands, Timor-Leste, Vanuatu, and Vietnam were reviewed. Data on 128 indicators, including ARH outcomes, outcomes for babies of adolescent mothers, and adolescents’ access to health information and services, were mapped. Available data are limited because of the omission of cohorts such as young adolescents (10-14 years old) and, in many surveys, unmarried women; the omission of important indicators; and failure to report data disaggregated by age. DHS and MICS reports have limited capacity to inform policy and programs to improve ARH. A review of DHS and MICS sampling strategies and reporting templates, and a consideration of alternative data collection strategies, are warranted.
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Crabtree, Susan, and Hilary Clare Tolley. "Governance for maternal and neonatal health." International Journal of Health Governance 23, no. 1 (March 5, 2018): 4–17. http://dx.doi.org/10.1108/ijhg-06-2017-0030.
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Purpose The purpose of this paper is to report on a postdoctoral research study examining the importance of multi-level leadership and health governance for ensuring the implementation of national and provincial health sector strategies that aim to improve maternal and neonatal health (MNH) in low- and middle-income countries (LMICs). Design/methodology/approach A descriptive-interpretive qualitative, institutional approach was undertaken to explore the impact of provincial and district governance mechanisms on the delivery of MNH services in two districts in East New Britain Province (ENBP), Papua New Guinea (PNG). Data were collected from 12 key informants. Informants were selected on the basis of their direct involvement in health system management and deployment of health at provincial and district health governance levels. Findings The analysis revealed alignment between global strategies and national and provincial policy, suboptimal provincial government support related to implementation of policy, divergent data between districts and a disconnect between the local governance mechanisms and a donor-funded initiative for raising midwifery education. Research limitations/implications This qualitative study was limited by the small sample size and does not claim to be representative of ENBP or other provinces in PNG. Originality/value This paper contributes empirical evidence to the literature on health policy, leadership and governance for MNH, by recognising and exploring the formal and informal rules at play in a given context, and examining how they are made, changed, monitored and enforced. These insights are critical to understanding how the system actually functions (or not) to implement MNH strategies in LMICs.
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Warner, Jeffrey, and Catherine Rush. "Tropical fever in remote tropics: tuberculosis or melioidosis, it depends on the lab." Microbiology Australia 42, no. 4 (2021): 173. http://dx.doi.org/10.1071/ma21049.
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Diagnostics tests used to identify the cause of infection using proteomics and genomics have revolutionised microbiology laboratories in recent times. However, approaches to build the capacity of clinical microbiology services in the rural tropics by simply transplanting these approaches have proven difficult to sustain. Tropical fever in the remote tropics is, by definition, a clinical diagnosis where the aetiology of fever is not known, treatment is empirical, guided by clinical suspicion with treatment failure often attributed to incorrect diagnosis or antimicrobial resistance. Tuberculosis (TB) in rural Papua New Guinea (PNG) is mostly diagnosed clinically, perhaps supported by microscopy. In fact, a ‘tuberculosis patient’ in rural PNG is included in the TB register upon commencement of TB treatment with or without any laboratory-based evidence of infection. The roll-out of GeneXpert is continuing to transform TB diagnostic certainty in TB endemic communities. Melioidosis is endemic in tropical regions and is increasingly reported to mimic TB. Isolation and identification of the causative agent Burkholderia pseudomallei remains the gold standard. Here, we discuss the increasing divide between rural and urban approaches to laboratory-based infection diagnosis using these two enigmatic tropical infectious diseases, in rural PNG, as examples.
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Fitzpatrick, Jane. "An Exploration of the Experiences of Migrant Women." International Journal of User-Driven Healthcare 2, no. 3 (July 2012): 9–23. http://dx.doi.org/10.4018/ijudh.2012070102.
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Women across the world migrate for a wide range of reasons. Some gravitate to urban centres in their own countries seeking safety, education, health care, and employment opportunities. Others travel across national boundaries seeking reprieve from the atrocities of war and extreme poverty. Migration within countries is on the rise, as people move in response to adverse conditions such as lack of resources, services and education, and employment opportunities. In addition they may want to escape from violence or natural disasters. This movement of people from rural to urban areas has resulted in an explosive growth of cities around the globe. This paper draws on a research case study undertaken with the Kewapi language group in Port Moresby and the Batri Villages of the Southern Highlands in Papua New Guinea. It seeks to highlight the perspectives of women traveling vast distances from their home communities in order to seek education and health care. It explores the implications for developing effective service user focused health care systems designed to meet the needs of mobile and vulnerable women. The study suggests that if women and their families from remote rural communities are encouraged and facilitated in participating in health promoting initiatives they can dramatically improve their life and health experiences and that of their community.
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Baigry, Maggie Ikinue, Robin Ray, Daniel Lindsay, Angela Kelly-Hanku, and Michelle Redman-MacLaren. "Barriers and enablers to young people accessing sexual and reproductive health services in Pacific Island Countries and Territories: A scoping review." PLOS ONE 18, no. 1 (January 26, 2023): e0280667. http://dx.doi.org/10.1371/journal.pone.0280667.
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Background The number of young people utilising sexual and reproductive health services in Pacific Island Countries and Territories remains poor despite the availability and the existence of the fundamental rights to access these services. Adolescents and youth need accurate information and timely access to contraceptives to prevent adverse consequences associated with unintended pregnancies, abortion, childbirth and untreated sexually transmitted infections. This scoping review identifies and analyses factors contributing to young people’s low access to sexual and reproductive health information and services in this region. Methods Guided by the PRISMA Scoping review guidelines, we searched three databases (Medline Ovid, Scopus and CINAHL Complete) for peer-reviewed articles published between 1st January 2000 and 31st August 2020 that reported on factors, including barriers and enablers, affecting access to sexual and reproductive health information and services by young people living in Pacific Island Countries and Territories. We assessed the quality of each study according to the study designs, methods of data collection, data analysis and ethical considerations. All information was sorted and organised using an Excel Spreadsheet. Text data from published articles were charted inductively using thematic analysis with no predetermined codes and themes. Findings Five hundred eighty-nine articles were screened, and only eight met the inclusion criteria outlined in this scoping review protocol. These eight articles reported studies conducted in four Pacific Island Countries and Territories: Cook Islands, Fiji, Papua New Guinea, and Vanuatu. Factors such as lack of accurate sexual and reproductive health knowledge and social stigma were the leading causes of young people’s limited access to sexual and reproductive health services. Cultural and religious beliefs also invoked stigmatising behaviours in some family and community members. Conclusion This scoping review revealed that social stigma and judgemental attitudes imposed by family and community members, including healthcare providers, hinder young unmarried individuals in Pacific Island Countries and Territories from accessing sexual and reproductive health information and contraceptives. Alternatively, a non-judgmental healthcare provider is perceived as an enabler in accessing sexual and reproductive health information and services. Moreover, given that only a few studies have actually focused on young people’s sexual and reproductive health needs in the region, more research is required to fully understand the health-seeking behaviours of young people in their specific contexts.
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Cuthbertson, Joseph, Carol Stewart, Alison Lyon, Penelope Burns, and Thompson Telepo. "Health Impacts of Volcanic Activity in Oceania." Prehospital and Disaster Medicine 35, no. 5 (July 16, 2020): 574–78. http://dx.doi.org/10.1017/s1049023x2000093x.
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AbstractVolcanoes cause a wide range of hazardous phenomena. Close to volcanic vents, hazards can be highly dangerous and destructive and include pyroclastic flows and surges, ballistic projectiles, lava flows, lahars, thick ashfalls, and gas and aerosol emissions. Direct health impacts include trauma, burns, and exacerbation of respiratory diseases. Far-reaching volcanic hazards include volcanic ashfalls, gas and aerosol dispersion, and lahars. Within Oceania, the island arc countries of Papua New Guinea (PNG), the Solomon Islands, Vanuatu, Tonga, and New Zealand are the most at-risk from volcanic activity. Since 1500ad, approximately 10,000 lives have been lost due to volcanic activity across Oceania, with 39 lives lost since 2000. While volcano monitoring and surveillance save lives, residual risks remain from small, sudden, unheralded eruptions, such as the December 9, 2019 eruption of Whakaari/White Island volcano, New Zealand which has a death toll of 21 at the time of writing. Widespread volcanic ashfalls can affect the habitability of downwind communities by contaminating water supplies, damaging crops and buildings, and degrading indoor and outdoor air quality, as well as disrupting transport and communication networks and access to health services. While the fatality rate due to volcanic eruptions may be low, far greater numbers of people may be affected by volcanic activity with approximately 100,000 people in PNG and Vanuatu displaced since 2000. It is challenging to manage health impacts for displaced people, particularly in low-income countries where events such as eruptions occur against a background of low, variable vaccination rates, high prevalence of infectious diseases, poor sanitation infrastructure, and poor nutritional status. As a case study, the 2017-2018 eruption of Ambae volcano, Vanuatu caused no casualties but triggered two separate mandatory off-island evacuations of the entire population of approximately 11,700 people. On the neighboring island of Santo, a health disaster response was coordinated by local government and provided acute care when evacuees arrived. Involving primary care clinicians in this setting enhanced local capacity for health care provision and allowed for an improved understanding of the impact of displacement on evacuee communities.
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Taylor, Richard. "The Tyranny of Size: challenges of health administration in Pacific Island States." Asia Pacific Journal of Health Management 11, no. 3 (October 1, 2016): 65–74. http://dx.doi.org/10.24083/apjhm.v11i3.159.
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There is great diversity among Pacific Island states (n=22) in geography, history, population size, political status, endemic disease, resources, economic and social development and positions in the demographic and health transitions and their variants. Excluding Papua New Guinea, all Pacific states are less than one million, and half of them (11) are less than 100,000.
Smallness also means fewer resources available for health, even if percentage allocations are similar to larger countries, and a disproportionate amount may derive from international aid.
Specialisation is not cost-effective or even possible in clinical, administrative or public health domains in small populations, even if resources or personnel were available, since such staff would lose their skills. In instances where only one to two staff are required, retirement or migration means decimation of the workforce.
Training doctors within the Pacific Island region provides appropriately trained personnel who are more likely to remain, including those trained in the major specialities. Nursing training should be in-country, although in very small entities, training in neighbouring states is necessary.
Outmigration is a significant issue, however, opportunities in Pacific Rim countries for medical doctors are contracting, and there is now a more fluid workforce among Pacific health personnel, including those resident in Pacific Rim countries.
International and regional agencies have a disproportionate influence in small states which can mean that global policies intended for larger polities are often promulgated inappropriately in small Pacific states.Smallness also leads to strong personal relationships between health staff, and contributes to teamwork, but can also create issues in supervision.
Small health services are not just scaled-down versions of large health services; they are qualitatively different. Smallness is usually intractable, and its effects require creative and particularistic solutions involving other more endowed Pacific states and Pacific Rim countries.
Abbreviations: NCD – Non-Communicable Disease; NGOs – Non Government Organisations; ODA – Overseas Development Assistance; TFR – Total Fertility Rate.
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Mohamed, Yasmin, Martha Kupul, Janet Gare, Steven G. Badman, Selina Silim, Andrew J. Vallely, Stanley Luchters, and Angela Kelly-Hanku. "Feasibility and acceptability of implementing early infant diagnosis of HIV in Papua New Guinea at the point of care: a qualitative exploration of health worker and key informant perspectives." BMJ Open 10, no. 11 (November 2020): e043679. http://dx.doi.org/10.1136/bmjopen-2020-043679.
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IntroductionEarly infant diagnosis (EID) of HIV and timely initiation of antiretroviral therapy can significantly reduce morbidity and mortality among HIV-positive infants. Access to EID is limited in many low-income and middle-income settings, particularly those in which standard care involves dried blood spots (DBS) sent to centralised laboratories, such as in Papua New Guinea (PNG). We conducted a qualitative exploration of the feasibility and acceptability of implementing a point-of-care (POC) EID test (Xpert HIV-1 Qualitative assay) among health workers and key stakeholders working within the prevention of mother-to-child transmission of HIV (PMTCT) programme in PNG.MethodsThis qualitative substudy was conducted as part of a pragmatic trial to investigate the effectiveness of the Xpert HIV-1 Qualitative test for EID in PNG and Myanmar. Semistructured interviews were undertaken with 5 health workers and 13 key informants to explore current services, experiences of EID testing, perspectives on the Xpert test and the feasibility of integrating and scaling up POC EID in PNG. Coding was undertaken using inductive and deductive approaches, drawing on existing acceptability and feasibility frameworks.ResultsHealth workers and key informants (N=18) felt EID at POC was feasible to implement and beneficial to HIV-exposed infants and their families, staff and the PMTCT programme more broadly. All study participants highlighted starting HIV-positive infants on treatment immediately as the main advantage of POC EID compared with standard care DBS testing. Health workers identified insufficient resources to follow up infants and caregivers and space constraints in hospitals as barriers to implementation. Participants emphasised the importance of adequate human resources, ongoing training and support, appropriate coordination and a sustainable supply of consumables to ensure effective scale-up of the test throughout PNG.ConclusionsImplementation of POC EID in a low HIV prevalence setting such as PNG is likely to be both feasible and beneficial with careful planning and adequate resources.Trial registration number12616000734460.
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Kelly-Hanku, Angela, Michelle Redman-MacLaren, Ruthy Boli-Neo, Somu Nosi, Sophie Ase, Herick Aeno, Joshua Nembari, et al. "Confidential, accessible point-of-care sexual health services to support the participation of key populations in biobehavioural surveys: Lessons for Papua New Guinea and other settings where reach of key populations is limited." PLOS ONE 15, no. 5 (May 15, 2020): e0233026. http://dx.doi.org/10.1371/journal.pone.0233026.
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Dyer, R., M. Tafuna'i, I. Meredith, and D. Sarfati. "Cancer Care in Small Pacific Island States." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 214s. http://dx.doi.org/10.1200/jgo.18.86400.
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Background: Like other LMICs, many Pacific Island countries and territories (PICTs) have fragile and overburdened health systems with which to combat an increasing burden of cancer. Additionally, a combination of small geographically dispersed populations, limited resources, isolation and frequent natural disasters make cancer control in Pacific Islands also significantly different to elsewhere in the world. No prior work has provided a stocktake of current capacity for diagnosis and treatment of cancer across the region to date. Aim: To describe the specialized health services available for cancer control in the Pacific region, and show the complexity associated with accessing cancer care for Pacific Islanders. Methods: A cross-sectional review of medical services and human resources available for cancer control was undertaken for 21 Pacific Community (SPC) member countries and territories in April-May 2018 , specifically diagnosis (pathology and radiology) and treatment (chemotherapy, radiotherapy and surgical modalities and overseas referrals for services not available on-island) by contacting individual countries and territories. Common travel routes were mapped individually for 4 PICTs; Papua New Guinea, Solomon Islands, Kiribati and Tokelau; as examples of the unique challenges faced by rural dwelling Pacific Islanders when accessing the highest level of care available in-country. Results: Capacity for cancer diagnosis and care is extremely limited in the Pacific region. The exceptions are the 2 French territories (French Polynesia and New Caledonia) and Guam where a near full complement of services for diagnosis and treatment are operational. Some pathology services are generally available in the larger PICTs, while specimens are sent to affiliated off island laboratories for the rest. Plain x-ray and ultrasound are available at 1 or more locations in all PICTs. General and gynecologic surgery is the most widespread treatment modality available. Some to full chemotherapy administered in 7 and radiotherapy in 3 (formerly 4) PICTs. Overseas referrals for medical services not available in-country are a common feature to all PICTs health systems. A need to travel long distances to access health care is a challenged faced by Pacific Islanders on outer islands and rural villages. Examples will be presented. Conclusion: Cancer control services are few and far between in the Pacific region, and PICTs will always likely rely on overseas referrals for care not available. Access barriers exist for those on outer islands and in villages, and an unknown number seek treatment late or not at all for these reasons. Governments need to invest into strengthening primary and secondary care services, making them an option that is more easily accessible to remote populations. Collaboration between transport and health sectors to look at ways to improve frequency, regulation and safety of modes of transportation to outer islands to improve current systems.
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Bleakley, Erica. "Rehabilitation in EMTs: AUSMAT COVID-19 Deployments." Prehospital and Disaster Medicine 37, S2 (November 2022): s83. http://dx.doi.org/10.1017/s1049023x22001820.
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Background/Introduction:The WHO has recommended the inclusion of rehabilitation capabilities in EMTs responding to disasters and health emergencies since 2013. Likewise, the importance of rehabilitation input across the continuum of care for patients experiencing COVID-19 illness has been highlighted since the onset of the global COVID-19 pandemic. Despite recognition of the role and value of rehabilitation, both in EMTs and the management of COVID-19, evidence that EMTs activated in response to COVID-19 have deployed rehabilitation professionals remains limited.Objectives:This paper will describe the experiences of the Australian Medical Assistance Team (AUSMAT) in deploying rehabilitation professionals as an integrated capability of multi-disciplinary EMTs responding to COVID-19 health emergencies.Method/Description:In response to COVID-19 emergencies in Papua New Guinea, Fiji, Timor-Leste, and the Solomon Islands, AUSMAT deployed rehabilitation professionals alongside multi-disciplinary EMTs on four occasions in 2021-2022. The rehabilitation professionals engaged in direct clinical care and capacity-building activities.Results/Outcomes:The work of the deployed AUSMAT rehabilitation professionals facilitated important capacity building and support for local rehabilitation staff and services, enhanced the time critical multi-disciplinary training of local nursing and medical staff, and improved the quality of clinical care of COVID-19 patients.Conclusion:AUSMAT’s experience has demonstrated that the deployment of rehabilitation professionals as part of a multi-disciplinary team adds significant value to the work of EMTs responding to COVID-19 health emergencies. Nursing and medical staff cannot readily replicate the knowledge, skills, and perspectives of rehabilitation professionals. Appropriately skilled rehabilitation professionals should be deployed to support national rehabilitation staff when EMTs respond to health emergencies.
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Vallely, Lisa M., Pamela Toliman, Claire Ryan, Glennis Rai, Johanna Wapling, Carolyn Tomado, Savarina Huliafi, et al. "Prevalence and risk factors of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and other sexually transmissible infections among women attending antenatal clinics in three provinces in Papua New Guinea: a cross-sectional survey." Sexual Health 13, no. 5 (2016): 420. http://dx.doi.org/10.1071/sh15227.
Full textAbstract:
Background Papua New Guinea (PNG) is estimated to have among the highest prevalences of HIV and sexually transmissible infections (STIs) of any Asia-Pacific country, and one of the highest burdens of maternal syphilis globally. The prevalence of curable STIs, such as Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV), among pregnant women in PNG is relatively unknown. Methods: A cross-sectional bio-behavioural survey to investigate the epidemiology of CT, NG, TV and other STIs among pregnant women in three provinces of PNG was undertaken. Women aged 18–35 years attending their first antenatal clinic visit were invited to participate. Participants completed a short interview and provided self-collected vaginal specimens for CT, NG and TV laboratory-based nucleic acid amplification tests and a venepuncture specimen for laboratory testing for syphilis and Herpes simplex virus type-2 (HSV-2) serology. Routine antenatal assessment was conducted according to national guidelines, including HIV counselling and testing and point-of-care syphilis screening. Results: A total of 765 women were enrolled. Overall, 43% (95% confidence interval (CI): 39.2–46.4) had one or more of CT, NG or TV infection. CT was the most prevalent STI (22.9%, 175/765; 95% CI: 19.9–25.9), followed by TV (22.4%, 171/765; 95% CI: 19.4–25.4), and NG (14.2%, 109/765; 95% CI: 11.7–16.7). The prevalence of active syphilis was 2.2% (17/765; 95% CI: 1.2–3.3), HSV-2 was 28.0% (214/765; 95% CI: 24.8–31.2) and HIV, 0.8% (6/765; 95% CI: 0.2–1.4). Prevalences were highest among primigravid women, women aged <25 years, and among those in Central Province. Conclusion: High prevalences of curable genital STIs were observed among women attending routine antenatal clinic services in PNG. These infections have been associated with adverse pregnancy outcomes and could be important contributors to poor maternal and neonatal health in this setting.